Ivolol(Nebivolol )

Therapeutic Group: Beta Blocker

Presentation

Ivolol 2.5 : Each tablet contains Nebivolol hydrochloride INN equivalent to Nebivolol 2.5 mg.

Ivolol 5 : Each tablet contains Nebivolol hydrochloride INN equivalent to Nebivolol 5 mg.

Description

Nebivolol is a novel beta blocker. Nebivolol is a racemate of two enantiomers, d-nebivolol and l-nebivolol. Nebivolol has unique pharmacologic properties, including very high selectivity for β1 – receptor and nitric oxide-mediated vasodilatory effect. Nebivolol reduces heart rate & lowers blood pressure at rest as well as during exercise.

Indications

Nebivolol is indicated in treatment of essential hypertension and treatment of stable mild and moderate chronic heart failure.

Dosage & Administration

Hypertension
Adults: 5mg daily, preferably at the same time of the day.
Elderly (In patients over 65 years): The recommended starting dose is 2.5 mg daily. The dose may be increased to 5mg daily if needed.
Patient with renal insufficiency: The recommended starting dose is 2.5 mg daily. The daily dose may be increased to 5mg if needed.
Patients with hepatic insufficiency: Data in patients with hepatic insufficiency or impaired liver function are limited. Therefore the use of Nebivolol in these patients is contra-indicated.
Chronic Heart Failure
The initial uptitration in case of chronic heart failure patients should be done according to the following steps at 1-2 weekly intervals based on patient’s tolerability.
1.25mg daily, to be increased to 2.5mg once daily, then to 5mg once daily and then to 10mg once daily. The maximum recommended dose is 10mg daily.

Side Effects

The most common side effects are headache, nausea and bradycardia.

Precautions

Patients with coronary artery disease treated with Nebivolol should be advised against abrupt discontinuation of therapy. Caution should be exercised in patients with circulatory disorders, first degree heart block, anesthesia, diabetes, hyperthyroidism, chronic obstructive pulmonary disorders and allergen sensitivity.

Use in Pregnancy & Lactation

Nebivolol is contra-indicated in pregnancy and lactation.

Drug Interaction

As Nebivolol metabolism involves the CYP2D6 isoenzyme, co-administration with substances inhibiting this enzyme, especially paroxetine, fluoxetine, thioridazine and quinidine may lead to increased plasma levels of nebivolol associated with an increased risk of excessive bradycardia and adverse events.

Over Dose

The symptoms of overdose are bradycardia, hypotension, bronchospasm and acute cardiac insufficiency.

Commercial Pack

Ivolol 2.5: Each box contains 3 blister strips of 10 tablets
Ivolol 5: Each box contains 3 blister strips of 10 tablets.